HomePhilippine Journal of Otolaryngology Head and Neck Surgeryvol. 24 no. 2 (2009)

Extramedullary Plasmacytoma in the Maxillary Sinus

Jennifer De Silva-leonardo | Rosario R. Ricalde | Jose Roberto V. Claridad | Erasmo Gonzalo DV Llanes

 

Abstract:

Objective: To describe an intranasal mass initially diagnosed and treated as benign that
eventually turned out to be a malignant extramedullary plasmacytoma of the maxillary sinus
and to review the literature on its presenting signs and symptoms, diagnosis, management and
pathophysiology.
Methods:
Design: Case Report
Setting: Tertiary Public Hospital
Patient: One
Results:A 45-year-old male with persistent nasal obstruction and intermittent epistaxis underwent several biopsies of a mass shown on computed tomography scans as heterogeneously enhancing, expansile, occupying the left maxillary sinus with extension into the left nasal cavity with areas of erosion. Immunohistochemical staining was negative for cytokeratin (CK) and leukocyte common antigen (LCA). Complete excision yielded a final histopathologic interpretation of plasmacytoma. Laboratory examinations excluded multiple myeloma. The final diagnosis was extramedullary plasmacytoma and he was treated with post-operative adjuvant radiotherapy.
Conclusion: Plasmacytoma may present in the sinu-nasal region and be part of a systemic
disease like multiple myeloma. A high index of suspicion and thorough initial histopathological
work-up may help in establishing a definitive diagnosis and providing optimum treatment.